I sent emails to EVERY person on my list, whether they live in my area or not. I asked them to tell ANYperson they thought might be interested, that I was starting out as a doula. A friend told a friend of hers, S, who is a Bradley instructor. S invited me to come to one in the series of Bradley classes that talks about doulas and birth plans. She liked me (we're now good friends, actually!), and asked me to come to EVERY one of that class in her series. I actually got two of my first six clients from that first class that I attended, and probably about half of my clients in the first year I was in practice from speaking at subsequent classes. Now I get most, if not all, of my clients from word of mouth, at least half of which are derived from those clients that I got from speaking at her class.
The other half? Well, I started out posting in freecycle. I know that MANY professionals here have had really bad experiences doing births for free, but I found the complete opposite situation. I live in an affluent area, but it is surrounded by very, very poor areas. We happen to have well educated women in those poor areas. Women who are stuck with medicaid, and the really crappy maternity care that goes along with it. Four women contacted me from my freecycle ads, and three of them ended up as my clients. They attended every single meeting, they called me for their births, they soaked up every piece of new information that I gave them, and they had a much more self-empowered birth because they felt as if having a doula with them gave them a voice that they would not other wise have had. NOW. I put out gas money, and other business expenses for those births, yes. However, as in any other start-up business, I considered those expenses to be crucial in getting my business off on the right foot. I needed the experience, they needed a doula, we traded off. As a matter of fact, I believe that EVERYTHING I have is gift, and so am happy to use my gift of doing a good job of attending women in labor to benefit others who otherwise would have a much less satisfactory birth for one reason or another. Yes, I do it to help support my family, so I am unable to do free births all the time, but still consistantly end up doing one free birth a quarter, and am still quite happy to. Actually, the ONLY mama who never called me during labor was probably the most affluent one I've had to date...the tiny sum (compared to what she and her husband bring in) that they pay me is nothing to her, so she really didnt mind when the first active contraction hit, and she decided to run to the hospital, and get the epidural, that her husband felt bad calling me out of bed in the middle of the night to watch her sleep with an epidural. Funny, how things are different from different perspectives.
Also, I networked. I spent several days in the car going to area yoga studios and chiropractors. Can't say that helped. After doing other kinds of networking (getting to know the members of the midwifery and natural birth worker community in my area) I have found that most yoga instructors and chiropractors in my town have one certain doula to whom they already refer (each having their own favorite)...my chiro now refers to me! BUT, networking within the midwifery and natural birth worker community has been a great boon to my business. I have formed friendly acquaintences and friendships with some of those women, and have found that I like many of their styles, and refer certain clients with certain needs to certain midwives.

And the midwives refer back. I refer to other doulas when I can't, for one reason or another, take a specific client. They refer back. I refer to other CBE's (mainly my Bradley friend, but sometimes if they're not in her area and don't want to drive, to others as well).
It all takes time. I did get my first six clients booked within about a three week period...but in GENERAL, it takes time to build the rest of the business, the connections and such. Last year I averaged two clients a month. This year, including the fact that I am now also a midwive's assistant, I average four to five births a month...and am counting down the DAYS till february, when I have my first month off since...I can't remember when! And then I'm also not taking clients in the month of April, as I'll be off to Europe to visit family for a well deserved (if I DO say so myself) anniversary vacation. *dreaming of greener shores*

Have fun, and take time to grow your business. My husband is quite happy that I took the time to go to all the birthnetwork, doula coffee nights, mdc coffee nights, and such over the first year (and still do), now that we're seeing the payoff!